Peri‐operative challenges and long‐term outcomes in liver transplantation for polycystic liver disease

AbstractBackgroundThe purpose of this study was to determine peri‐operative mortality and long‐term outcomes in patients undergoing liver transplantation in the US using the United Network for Organ Sharing (UNOS) database.MethodsThis study is a retrospective review of liver transplantations (LT) recorded in the UNOS database performed between 1988 and 2010. In total, 107 411 LT were performed in the US, 357 (0.3%) were for adult polycystic liver disease (PLD). A random group of 9416 adult patients transplanted for other diagnoses was created for comparison (10% of the adult non‐PLD database).ResultsTwo hundred and seventy‐one patients in the adult PLD group were females (75.9%), the mean age was 52.3 ± 8.2 [standard deviation (SD)] years. The median length of transplantation hospital stay was 11 days (interquartile range 8–21). Patients from the PLD group versus the comparison group (9416 patients) consisted of more females, lower Model for End‐Stage Liver Disease (MELD) scores (17 versus 21 points), more multi‐organ transplants (41% versus 4 %), chronic renal failure (creatinine 2.7 versus 1.5) and fewer patients with chronic hepatitis C (1.4% versus 32%). Peri‐operative mortality (≤30 days) was 9% in the PLD versus 6% in the comparison group; however, at 1 year PLD survival was similar (85% versus 85%) to other diagnoses and better at 3 (81% versus 77%) and 5 years (77% versus 71%, overall Log Rank P = 0.006). A similar PLD survival advantage was observed in isolated initial transplants (P = 0.019).ConclusionIn spite of early technical challenges and mortality, transplantation should be considered an option for selected patients with PLD as excellent long‐term outcomes can be achieved